Drainage tube with means for scraping away debris therewithin



Dec. 17, 1968 A; R. GROSSMAN DRAINAGE TUBE WITH MEANS FOR SCRAPING AWAYDEBRIS THEREWITHIN Fild July 24, 1964 INVEN TOR. ALA/V RICHARD GROSS/MANATTORNEY 3,416,532 DRAINAGE TUBE WITH MEANS FOR SCRAPING AWAY DEBRISTHEREWITHIN Alan Richard Grossman, 9201 Sunset Blvd., Los Angeles,Calif. 90069 Filed July 24, 1964, Ser. No. 384,918 3 Claims. (Cl.128350) ABSTRACT OF THE DISCLOSURE A drainage tube is described made ofbendable material, such as plastic, so that the whole tube is flexible.The tube is formed of two sections, an outer section with a distal endwhich is closed and with perforations adjacent this end. The outer tubeis sufiiciently long so that its proximate end extends outside of apatients body when the tube is inserted for drainage. This end is opento the atmosphere. An inner tube of smaller diameter fits into the outertube and forms therewith an annulus. The distal end of the inner tube,which can extend near to the distal end of the outer tube, is open andis cut ofi so that there are relatively sharp edges. If desired, it maybe cut beveled to increase the sharpness of one of the edges. The lengthof the inner tube from distal end to proximate end is greater than thatof the outer tube, and at its proximate end it is attached to a suctionfitting so that a partial vacuum can be applied. The small inner tubecan be removed and it or a replacement reinserted without touching thetissues of the patient; and if there is any plugging of the perforationsnear the distal end of the outer tube, the inner tube may be moved upand down and its relatively sharp edges at its distal end serve toscrape out debris or other material plugging the perforations in theouter tube. As the annulus between inner and outer tubes is open to theatmosphere, there is no vacuum applied to the tissues of the patientthrough the perforations and there is, therefore, no risk of suckingtissue in through the perforations, with resulting pain and clogging.

Background of the inventionv In the past drainage tubes have been usedvery extensively both to drain out such exudates as pus in abscesses andthe like and drainage from surgical operations. It is normal to leavedrainage tubes in the body cavities after surgical intervention or tointroduce drainage tubes into such things as abscesses and the like. Thedistal end of the tube has perforations and theoretically the pressureof muscles, as the patient moves somewhat, is supposed to cause theexudate from the wound, or other site to be drained, to flow out. Thishas proven to be of limited value in cases where there is not sufiicientmovement of the patient and it is easy for an ordinary drainage tube toclog up.

An improvement has been developed and used for many years in which thedrainage tube is double walled with perforations in the outer wall ofthe tube which has a closed distal end, and an inner tube which extendsout of the drainage tube into a connection to a source of suction. Thesuction permits removal continuously of the fluids which are to bedrained, and has proven more satisfactory. However, it still has certaindrawbacks. Thus it is still possible for the distal end of the innertube to be clogged either by coagulation of fluids such as blood orpieces of tissue becoming lodged. When this occurs the tube has to beremoved, which is almost always quite a painful procedure requiring theintervention of the surgeon, and a new drainage tube is inserted whichis also painful; in effect the procedure might be considered as a minoroperation. Not only is there pain and addi- United States Patent tionalsurgical intervention but in many cases it is undesirable to create thepossibility of further irritation and introduction of infection.

Summary of the invention Essentially in the present invention there is aclosed end outer tube with perforations adjacent its distal end just asin the ordinary suction drainage tube but the central tube is removableand the other end of the outer tube is open. This results in twoimportant advantages. One, air can be drawn in between the outer tubeand the inner tube which tends to discourage clogging of theperforations and if nevertheless clogging does occur, the inner tube canbe removed without any pain to the patient, and by moving it up and downits end tends to scrape off clots, pieces of tissues and the like andthen a new tube can be reinserted. All of this is effected withoutirritation and pain to the patient and does not require surgicalintervention as it can be performed by any reasonably technicallyskilled person such as a nurse.

It is also possible to use quite a small inner tube because if its opendistal end clogs it can be withdrawn, whereas in the one piece drainagetube formerly used the inner tube must be large enough so that itsdistal end will not be likely to clog and this in turn requires a largerouter tube which means that there is alarger opening remaining in thepatient. This is particularly undesirable if the tube has to beinserted, for example into an abscess without surgically opening up thepatient. It is not as important in the case of a drainage tube from anoperation as in the latter case the tube is inserted before the openingis sewed up. Nevertheless the smaller the tube which will reliablyoperate, the better, and so the possibility of a much smaller size is ofvalue even if the tube is used for drainage after a surgical operation.

Not only does the drainage tube of the present invention provide forimproved reliability and elimination of unnecessary painful removal fromthe patient, but it is actually cheaper for the sealing in of the innertube, which was necessary before it can be dispensed with and the innertube can be of ordinary tubing which is made in great lengths and simplycut off at the length desired. Similarly the perforated outer tubingwhich is sealed at the distal end may also be made in various lengthsand the excess length cut oif where not needed. Thus a single sizepermits use in various situations where the length of the drainage tubemay vary.

When the inner tube is cut off initially or subsequently in longlengths, the distal end has relatively sharp edges even if the tube iscut straight across. It should be understood that the edges are onlyrelatively sharp and are not sharp in the sense of a knife or othersurgical instrument. If desired, and this is a preferred embodiment, thedistal end of the inner tube may be beveled so that at its beveled endthere is an even sharper edge. These relatively sharp edges tend toscrape otf debris which may have clogged the perforations near thedistal end of the outer tube, and the debris may be sucked out throughthe inner tube or if it should be large enough to clog the distal end ofthe inner tube, the latter can be removed and reinserted. The cutting orscraping off of debris is effected without the moving inner tubecontacting the tissues of the patient and is, therefore, substantiallypainless, and debris, such as clots and cells, which may plug theperforations should not be confused with the sucking in of tissue whichactually occurred in the past when the drainage tubes were subjected tovacuum, which tended to pull tissues into perforations at the distal endof the drainage tube. This can be quite painful.

FIG. 1 illustrates, in a somewhat diagrammatic manner, a drainage tubeinstalled in a patient, and

FIG. 2 shows part of the tubes in section.

Description 07 the preferred embodiments The patients skin surface isshown at 1 with the outer tube 2 penetrating into the patient, sealed atits distal end 3 and provided with perforations 4. An inner tube 5 witha. slant-cut distal end 6 and a proximate end which extends into aplastic adaptor 7 which can be attached to a source of suction shown onthe drawing as rubber tubing 8. The inner tube is shown extending downto the distal end of the outer tube but of course it may have its distalend somewhat above the closed distal end of the perforated tube and thisis often desirable. When suction is applied air flows in around theinner tube through the annulus between the tube and the proximate end ofthe outer tube and blood or other exudate which penetrates theperforations 4 is sucked up through the central tube 5. This is shown inthe drawings with appropriate arrows.

If clogging of the perforations takes place the inner tube is moved inand out and the slanted edge of its distal end tends to scrape off clotsor other clogging of the perforations. This operation can be carried outby the nurse and does not pain the patient because the movement of theinner tube is inside the outer tube and there is no movement in contactwith the sensitive tissues of the patient. If the inner tube clogs, itis completely removed and a new one substituted. This also requires nosurgical intervention, does not produce pain in the patient and can becarried out by hospital personnel such as nurses. Needless to say theproper aseptic environment must be maintained.

The simple inner tube shown in the drawings, which will normally be ofsuitable plastic, is ordinarily satisfactory for most drainageoperations. Where, however, very severe clogging is anticipated andparticularly where it is highly undesirable to irritate the patient byremoving the outer tube, it is possible to provide the distal end of theinner tube with a hardened projection such as metal so that it willscrape off clots from the perforations when withdrawn. Ordinarily thisis not necessary because the distal end of the ordinary inner tube iscut with relatively sharp edges which are suflicient for removing debrisin most cases but such special inner tubes are not excluded from thepresent invention.

I claim:

1. A flexible drainage tube made of readily bendable material fordraining fluids and suitable for placement in a body cavity, saiddrainage tube having a flexible outer tube with a closed distal endprovided with perforations adjacent thereto, the tube being ofsufficient length so that its proximate end extends beyond the bodycavity into the atmosphere, and an inner tube extending into the outertube and removable therefrom, said inner tube being of bendable materialand having an open ended tip at its distal end with relatively sharpedges at the open end of the tip and length sufficiently longer than theouter tube to extend substantially beyond the proximate end of the outertube, said inner tube being of sufficiently smaller external diameterthan the internal diameter of the outer tube so that an annularpassageway is formed between the two tubes and this annular passagewaycommunicates with the atmosphere at the proximate end of the outer tube,which protrudes from the body cavity, whereby moving the inner tubewithin the outer tube causes the relatively sharp edges of its distalend to scrape off debris accumulating in the perforations of the distalend of the outer tube.

2. A drainage tube according to claim 1 in which the open ended tip atthe distal end of the inner tube is provided with a beveled cutting edgefor scraping oif the debris from the perforations of the outer tube whenthe inner tube is moved therein.

3. A drainage tube according to claim 1 in which the proximate end ofthe inner tube outside of the outer tube is provided with a detachablefitting.

References Cited UNITED STATES PATENTS 985,865 3/1911 Turner 128--278 X2,525,329 10/1950 Wyzenbeek 12s 347 2,614,563 10/1952 Devine' 1282762,642,873 6/1953 Rice 128-347 DALTON L. TRULUCK, Primary Examiner.

US. Cl. X.R. l28276

